Our ability to remember allows each experience to prime our brains for the next experience. Our experiences collectively reflect not just our individual history, but also of who we are and who we become. Memory informs our habits, fears, hopes, and how we relate to one another. It’s also a critical tool from infancy and throughout life, shaping us and our footprint in the world.
While there are different types of memory (immediate, working, and long-term), each type is tied to intricate brain function, specifically, the everchanging connections between neurons (nerve cells). Our brain is capable of relating our senses to our impressions, creating an abstract, dynamic connection originating from the neural activity throughout the brain.
With memory at the core of what makes us “us,” it isn’t difficult to see the devastation that comes if memory begins to deteriorate.
What is Dementia?
The National Institute of Aging defines dementia as the loss of cognitive functioning including thinking, remembering, and reasoning, as well as behavioral abilities to the extent that it interferes with acts of daily living .
According the the Centers for Disease Control and Prevention (CDC), Alzheimer disease (AD), the most common form of dementia, is now in the top 5 leading causes of death in the United States, with nearly 5 million people in the U.S alone and 50 million worldwide currently living with the disease [1, 4]. Furthermore, it’s estimated that approximately 15-20% of people are living with mild cognitive impairment (MCI), which is categorized by cognitive function severe enough to be detected and likely noticeable to others . While those with MCI may not notice disruptions in their daily life or find that it detracts from their independence, it’s estimated that more than 20% of Americans over age 65 fall into this group .
It’s projected that by 2050, as many as 1 million new cases of Alzheimer’s will be diagnosed each year, with upwards of 132 million people globally living with AD. This doesn’t even account for countless other cases of other forms of cognitive impairment .
Cognitive impairment of any kind can pose a significant burden for the individual as well as their friends, family, and caregivers. With AD and MCI on the rise, and without a definitive pharmaceutical treatment, it warrants further investigation into the various preventive measures . Unfortunately, one of the difficulties for available treatments is that they’re administered at a later stage in the disease progression, not during the pre-symptomatic period. What was initially thought to be a disease of the brain, ongoing research is now revealing that AD is a systemic disease thataffects the brain.
A Deeper Look into Alzheimer’s Disease
Alzheimer’s disease was first described in 1906, though it wasn’t until about 70 years later that it became a more prevalent topic of research . Preliminary research began to recognize that AD started several years before symptoms, as well as identify that the progression of signs and symptoms of AD and dementia can differ greatly among individuals . The changes that occur in those with AD often reflect the degree of damage to the neurons in various areas of the brain .
In general, there are key neuropathological features in AD, one being the buildup of amyloid plaques between the neurons, which disrupt communication throughout the brain . Another is neurofibrillary tangles (NFT), which are twisted fibers found inside brain cells, made up primarily of a protein called Tau . Tau makes up part of the microtubule, or transport system, that delivers nutrients to nervous cells . NFTs have been found in the visual association areas of the brain while amyloid plaques have been identified across visual and primary areas . A third feature of AD is neuron and synapse loss, which creates a deficit in key neurotransmitter function involved in working memory . It’s these cholinergic (neurotransmitter) deficits that are at the forefront of many current treatments .
Dr. Bredesen’s Work and the Three Subtypes of Alzheimer’s
According to the renowned work by Dr. Dale Bredesen and his colleagues, Alzheimer’s disease is now understood not as a single disease, but rather involves processes resulting from several factors including inflammation, chronic pathogens, insulin resistance, vascular compromise, trauma, and toxin exposure . Furthermore, a groundbreaking randomised controlled trial published in the Lancet (2015) found that a multidomain intervention may improve or maintain cognitive functioning by addressing lifestyle factors such as diet, exercise, cognitive training, and vascular risk monitoring . With advances in research and further insight on the various contributing factors to cognitive decline, there is rising hope.
Dr. Bredesen’s research is characterized by a multiphasic approach rather than a monotherapeutic or monophasic approach, similar to that of the Lancet study. He and his team have since developed a 36 point ReCODE protocol, which is based on Functional Medicine principles, relying on a personalized, multi-modal approach specifically targeting metabolic dysregulation, hormone imbalances, immune system dysfunction, detoxification, and social-emotional restoration. Though this protocol requires strict compliance, reversal of cognitive impairment has been shown to be possible .
Additionally, Dr. Bredesen has identified three subtypes of Alzheimer’s, further refining individualized treatment plans .
Bredesen’s Three Subtypes:
Type 1: Associated with inflammatory processes.
Type 1.5: Typically associated with glycotoxicity, or impaired glucose regulation, which creates a pro-inflammatory state as a result of insulin resistance and disrupted hormone signaling.
Type 2: Associated with reductions in trophic supports, such as hormones, vitamins and other.
Type 3: This type does not relate to familial association or APOe4 gene mutations. Rather, Type 3 is associated with chemical toxicant and/or biological toxin exposure, in addition to significant life stress. It’s also not uncommon for this type to present at younger ages, often beginning with poorer word recall, trouble with math calculations, and even depression. Heavy metal accumulation and toxicity can be a significant contributor to cognitive decline, especially as amyloid-B acts as a heavy metal binder.
What about genetics?
The three genes associated with Alzheimer’s are known as Apolipoprotein E (APOe) 2, 3, and 4. Variations in the APOe 4 genes pose the greatest risk for developing AD.
Types 1, 1.5, and 2 are associated with mutations of the APOe4 gene, however, with ongoing advances in epigenetic(how are genes are expressed)research and genomic medicine, there’s more opportunity for prediction, and therefore, prevention.
The Bredesen Protocol
The Bredesen Protocol provides a blueprint for a Functional Medicine provider to support patients by overseeing their personalized plan. The Bredesen Protocol, or ReCODE, focuses on identifying and treating potential infectious pathogens, restore gut function and heal intestinal permeability, identify insulin resistance or other metabolic disturbance, correct nutrient deficiencies as well as hormonal imbalances and vascular support, and identify toxins while working to reduce exposure and promote detoxification . Because each patient has a different combination of the many possible contributors, each treatment plan is personalized and targeted to the individual’s needs .
What you can do right now for better brain health and prevention:
Regular, adequate sleep is essential for the brain! Did you know that your brain actually shrinks while you sleep to allow for glymphatic drainage? This allows for significant detoxification in the brain itself .
Research is showing that chronic, low levels of toxin exposure can bioaccumulate in the body, which poses significant risk to brain function . Consider swapping out your personal care products for more natural ones, such as cosmetics, hair care, and anything containing fragrance. Ensure you’re drinking adequate filtered water on a daily basis in addition to using an air purifier in the spaces you spend the most time. To protect yourself from heavy metals, consider seeing a biological dentist for mercury amalgam removal and ensure you wear protective clothing when necessary. Prioritize organic, whole foods and remember to store them in glass or stainless steel, avoiding plastic or aluminum. Optimize your micronutrient intake by eating a variety of vegetables and fruits.
Remember that stress is a toxin too, and can have detrimental effects on numerous physiological processes in the body, especially the brain. Find activities you enjoy on a regular basis and find ways to alleviate stress such as meditation, deep breathing, or even Emotional Freedom Technique (EMT).
As a reference to check what products you’re using and which foods you’re consuming, check out the Environmental Working Group database at ewg.org.
Exercise Your Body and Mind
While it’s also crucial to find daily activities to keep your body moving, it’s also important to exercise your mind! Physical activity and regular exercise provides significant benefits for the whole body, with some being immediate. In addition to your exercise regimen, consider trying BrainHQ, an app designed to help with cognitive training and enhance learning and memory.
- Deaths: Final Data for 2016
- 2018 Alzheimer’s Disease Facts and Figures
- 2016 Alzheimer’s Disease Facts and Figures
- Lifestyle Factors of Alzheimer’s Disease
- Basics of Alzheimer’s Disease and Dementia: What is Dementia?
- Reversal of Cognitive Decline: 100 Patients
- Understanding the Pathophysiology of Alzheimer’s Disease and Mild Cognitive Impairment: A Mini Review on fMRI and ERP Studies
- A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial
- Reversal of cognitive decline in Alzheimer’s disease
- Metabolic profiling distinguishes three subtypes of Alzheimer’s disease
- Inhalational Alzheimer’s disease: an unrecognized—and treatable—epidemic
- Brain may flush out toxins during sleep
- Toxicant Exposure and Bioaccumulation: A Common and Potentially Reversible Cause of Cognitive Dysfunction and Dementia